AB0241 COGNITIVE FRAILTY AND RISK OF FALLS AMONG EGYPTIAN OLDER ADULTS WITH RHEUMATOID ARTHRITIS
Authors: R. A. Elziaty, R. M. Abdel Kader
Journal: Annals of the Rheumatic Diseases (2022)

Background Rheumatoid arthritis (RA) is chronic autoimmune disease, affecting bone cartilage and predominantly joints, and causing inflammation and pain [2]. RA patients have disease-specific risk factors, including greater impaired balance, tender and swollen joints, lower muscle strength in their lower limbs, fatigability and medication side effects which contributes to a predisposition for falls [1]. Frailty, which was originally considered a geriatric syndrome, is an age-related decline in physiological reserve (3). It is associated with reduced muscle strength, exhaustion and with high inflammatory markers contributing to perpetuation of the frailty cycle (4). The concept of frailty is a recent issue in the rheumatologic field; by now, the prevalence of frailty among elderly individuals with RA has not been extensively examined and few studies on frailty in RA adults have been conducted. Objectives To assess the prevalence of cognitive frailty in people with rheumatoid arthritis and the relationship between cognitive frailty and falls. Methods In this cross-sectional study we evaluated 105 patients 60 years old or more with rheumatoid arthritis who fulfilled the ACR 2010 criteria and attended to rheumatology outpatient clinic in Ain-Shams University hospitals. Data was collected regarding demography and comorbidities. For cognitive and frailty screening, the Montreal Cognitive Assessment (MOCA) and frail scale were used respectively. Cognitive frailty (CF) is a clinical condition characterized by the simultaneous presence of physical frailty and mild cognitive impairment without functional impairment. Results 105 older adult patients with RA were studied of whom (72.4%) were females. The mean age of the study population was 66.03. We found that (12.4%) of the study group were cognitively frail and the prevalence of falls among cognitively frail patients was 92.3%. Table 1. No.= 105 Age Mean±SD 66.03 ± 4.29 Range 60 – 77 Gender Female 76 (72.4%) Male 29 (27.6%) Age/onset Mean±SD 36.41 ± 4.65 Range 27 – 48 Education Not educated 40 (38.1%) Educated 65 (61.9%) Cognitive frailty No 92 (87.6%) Cognitively frail 13 (12.4%) Frailty sore Frail 47 (44.8%) Pre frail 41 (39.0%) Robust 17 (16.2%) Figure 1. Conclusion The prevalence of cognitive frailty in geriatric people with rheumatoid arthritis was high and highly related to falls so screening for cognitive frailty in geriatric practice and the implementation of specific care is recommended. References [1]Brenton-Rule A, Dalbeth N, Menz HB et al: Are foot and ankle characteristics associated with falls in people with rheumatoid arthritis? A prospective study. Arthritis Care Res, 2017; 69: 1150–55 [2]Cross M, Smith E, Hoy D et al: The global burden of rheumatoid arthritis: Estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis, 2014; 73: 1316–22 [3]CLEGG A, BATES C, YOUNG J et al.: Development and validation of an electronic frailty index using routine primary care health interview and examination survey for adults (DEGS1). Bundesgesundheitsbl 2013; 56: 868-77 [4]DENT E, KOWAL P, HOOGENDIJK EO: Frailty measurement in research and clinical practice: A review. Eur J Intern Med 2016; 31: 3-10 Disclosure of Interests None declared